Sickle cell disease is a genetic disease of abnormal hemoglobin and red blood cells. It occurs in form of – sickle cell trait that affects tribals. According to the Indian journal of medical research, the prevalence of sickle cell carriers among different tribal groups varies from 1 to 40 percent. States like Madhya Pradesh have the highest load of sickle cell Anemia which particularly affects tribal women as they bear a child. There are high-risk pregnancies of anemia-affected tribal women in various states of the Bundelkhand region. As a result of anemia, neonatal, infant, and post-natal mortality rates remain high for tribal women across the region.
According to ICMR studies from 1986 to 2006, Red cell genetic disorders are prevalent among tribes among particularly vulnerable tribal groups PVTGs. Sahariyas of Gwalior, Baigas of Dindori, and Bharias of Chinndwara district are particularly vulnerable to these Red cell disorders. All these tribes are endogamous and have short marital distances hence share a gene pool restricted to a small geographical area. Subgroups of major tribes like Gond and Bhil from central Madhya Pradesh suffer from this genetic disorder to a great extent.
The use of alcohol and tobacco among tribes is quite prevalent. While NHFS 4 does not provide data on the use of tobacco and alcohol by background characteristics, NHFS recorded that 74. 1 % of the tribal population has been involved in the consumption of tobacco and alcohol. Thus figure was 65.6 for urban and 74.9 for rural areas. Other than this very little research is available on alcohol consumption among tribes of Bundelkhand. Other health concerns among tribal women include vaginal infection, fluorosis, congenital anomalies, neural tube defects, low birth weight babies, PCOD, cervical cancer, etc.
Tribal women develop various lung complications due to the usage of polluting fuels for cooking at home. The use of clean cooking fuels is three times more in non-tribal households as compared to tribal households.
The states of Madhya Pradesh and Uttar Pradesh will require special planning and targeted interventions for tribal communities especially women to improve their overall health indicators. There is a need to examine, understand and analyze the multi-
dimensional health determinants related to tribal women's health. This will form the first and the foremost step to planning an effective service delivery mechanism in the region.
SANITATION AND DRINKING WATER
According to the scheduled tribe women belonging to Saharias and Bhils, toilets
constructed under the SWACHH BHARAT MISSION -RURAL, there was no water supply. were merely three-walled structures as a result of which most of the toilets were rendered non-functional and hence converted into storerooms. Faulty designs of toilets are not conducive to privacy which deters women from using them.
As per the 2011 census, only 8% of households could access drinking water facilities within the households while the remaining 41.5% of tribal women had to fetch drinking water from faraway lands. According to the National Sample Survey report 2018-19( 76 th round), only 2.3% of the tribal population in the state of Madhya Pradesh had access to piped water inside residences as opposed to the non-tribal population with 11% access. This endangers serious socio-economic disparity among the social groups across the region.
According to the census 2011, access to drainage and sewerage covered with slabs is much lower in the tribal population as compared to non-tribal. Tribal Women and children in districts Damoa and Datia caught life-threatening diseases like malaria, jaundice, typhoid, and tuberculosis due to open drains near their households.
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